Provider Demographics
NPI:1669618112
Name:WINTERSTEEN, MARYLEE DUNN (MED)
Entity type:Individual
Prefix:
First Name:MARYLEE
Middle Name:DUNN
Last Name:WINTERSTEEN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 WESTERHAM
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441
Mailing Address - Country:US
Mailing Address - Phone:832-444-5954
Mailing Address - Fax:281-392-1643
Practice Address - Street 1:23922 CINCO VILLAGE CENTER BLVD.
Practice Address - Street 2:#111
Practice Address - City:KATYT
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-392-1130
Practice Address - Fax:281-392-1643
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist